Towards inclusive developmental neuroimaging: personalising virtual-reality (VR) and diffuse optical tomography (DOT) assessment for neurodivergent young children

Towards inclusive developmental neuroimaging: personalising virtual-reality (VR) and diffuse optical tomography (DOT) assessment for neurodivergent young children | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Towards inclusive developmental neuroimaging: personalising virtual-reality (VR) and diffuse optical tomography (DOT) assessment for neurodivergent young children Chiara Bulgarelli, Giulia Serino, Samuel Powell, Nadine Aburumman, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9558323/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Wearable neuroimaging methods hold considerable promise for identifying early biomarkers of neurodevelopmental conditions, yet their application to neurodivergent young children remains limited by significant participation barriers. We investigated inclusion rates and parental experiences in a combined virtual reality and diffuse optical tomography platform. Fifty-four 3-to-7-year-olds across three groups, neurotypical, elevated likelihood of Attention Deficit Hyperactivity Disorder (ADHD), and autistic were tested twice. Neurotypical and ADHD children engaged at consistently high rates, with near-ceiling task completion and equipment tolerance. Engagement in the autistic group was markedly more variable, shaped by equipment-related sensory sensitivities, particularly the shutter glasses and the cap, that persisted across visits despite targeted adaptations. Parental insights corroborated these findings: anticipated and experienced equipment concerns differed significantly across groups and remained elevated for autistic families throughout both visits. Signal quality in the autistic group was correspondingly lower and declined between visits, partly attributable to cap loosening for more sensitive children. Drawing on iterative parental co-design and industry partnership, we developed a four-phase personalisation framework covering pre-visit preparation, in-session adaptations, and engagement with device developers. We provide the first evidence base for inclusive wearable neuroimaging in neurodivergent children and a replicable framework for moving the field beyond one-size-fits-all protocols. Scientific community and society/Scientific community/Research data Biological sciences/Neuroscience Scientific community and society/Social sciences/Psychology/Human behaviour Full Text Additional Declarations Yes there is potential Competing Interest. This work involves the application of a technology developed by Gowerlabs Ltd, a UCL spin-out company, with which S.P. and N.E. are affiliated. Written informed consent was obtained from the participant’s caregiver prior to the start of the experiment. The study was approved by the ethical committee of the School of Psychological Science, Faculty of Science, Birkbeck, University of London (No. 2324007). PP acknowledge support by the Wellcome Trust (212979/Z/18/Z). Supplementary Files SM.docx Supplementary Materials Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9558323","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":632582683,"identity":"e0e55dfa-f073-48ce-8b5a-afac57accfc4","order_by":0,"name":"Chiara Bulgarelli","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9ElEQVRIiWNgGAWjYFACHgaGByCanbnhwMeGAwYQ0QMEtCSAaGbGhoMzSdbCzEuMFv4G3mMSCb/s8vmZGRsP2+64Y8zAfvgBM88Z3FokDvClSST2JVvObGZsOJx75pkZA0+aATPPDdxaDBh4zCQSe5gNDA6DtLQdtmFgyGFg5vlAUEu9gT1IiyVIC/8bIrQk/DhsYAD0/mHGtsNmDBIgW/A4TOIwX7JFYsNxAwmgLQd7zzwzZpN4ZnBwDh7v87f3Hrzx4U+1AX978+EPP3fcMeznT3744M0x3FoYmIGYsQ1JgI2BQERCwB/CSkbBKBgFo2AEAwAqglMO1l36ogAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0002-6153-137X","institution":"Birkbeck, University of London","correspondingAuthor":true,"prefix":"","firstName":"Chiara","middleName":"","lastName":"Bulgarelli","suffix":""},{"id":632582684,"identity":"9a9e0305-3db3-4818-ac3b-e4f74c7de977","order_by":1,"name":"Giulia Serino","email":"","orcid":"","institution":"Birkbeck, University of London","correspondingAuthor":false,"prefix":"","firstName":"Giulia","middleName":"","lastName":"Serino","suffix":""},{"id":632582685,"identity":"4b1fed9b-c20d-43d3-b168-cf2de5d75ed8","order_by":2,"name":"Samuel Powell","email":"","orcid":"https://orcid.org/0000-0003-0397-5121","institution":"University College London","correspondingAuthor":false,"prefix":"","firstName":"Samuel","middleName":"","lastName":"Powell","suffix":""},{"id":632582686,"identity":"a3975d62-757c-4b5f-b56a-88b0d36b1d48","order_by":3,"name":"Nadine Aburumman","email":"","orcid":"","institution":"Brunel University","correspondingAuthor":false,"prefix":"","firstName":"Nadine","middleName":"","lastName":"Aburumman","suffix":""},{"id":632582687,"identity":"23a90529-a637-46ec-8759-43949cf43356","order_by":4,"name":"Tony Charman","email":"","orcid":"https://orcid.org/0000-0003-1993-6549","institution":"King's College London","correspondingAuthor":false,"prefix":"","firstName":"Tony","middleName":"","lastName":"Charman","suffix":""},{"id":632582688,"identity":"20d290a1-e0e8-41a2-bb74-8bfaa3990925","order_by":5,"name":"Silvia Dalvit-Menabe","email":"","orcid":"","institution":"Babybrains Ltd.","correspondingAuthor":false,"prefix":"","firstName":"Silvia","middleName":"","lastName":"Dalvit-Menabe","suffix":""},{"id":632582689,"identity":"f7f81f12-29d5-425c-980e-32b1c4639d93","order_by":6,"name":"Nick Everdell","email":"","orcid":"","institution":"University College London","correspondingAuthor":false,"prefix":"","firstName":"Nick","middleName":"","lastName":"Everdell","suffix":""},{"id":632582690,"identity":"69b835e6-0ce3-429f-8e48-9a66dc8c5c52","order_by":7,"name":"Antonia Hamilton","email":"","orcid":"https://orcid.org/0000-0001-8000-0219","institution":"University College London","correspondingAuthor":false,"prefix":"","firstName":"Antonia","middleName":"","lastName":"Hamilton","suffix":""},{"id":632582691,"identity":"09f4f58a-6312-4776-b048-7aa03dff7f30","order_by":8,"name":"Siofra Heraty","email":"","orcid":"","institution":"Eirim, The National Assessment Agency","correspondingAuthor":false,"prefix":"","firstName":"Siofra","middleName":"","lastName":"Heraty","suffix":""},{"id":632582692,"identity":"704d39b7-4975-4c17-8e7f-f412eebbd495","order_by":9,"name":"Essi Viding","email":"","orcid":"","institution":"University College London","correspondingAuthor":false,"prefix":"","firstName":"Essi","middleName":"","lastName":"Viding","suffix":""},{"id":632582693,"identity":"61dcdd03-7261-4029-ae64-5b12e50f366f","order_by":10,"name":"Paola Pinti","email":"","orcid":"","institution":"Birbeck University","correspondingAuthor":false,"prefix":"","firstName":"Paola","middleName":"","lastName":"Pinti","suffix":""}],"badges":[],"createdAt":"2026-04-28 21:25:10","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":true,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-9558323/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9558323/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108805548,"identity":"047fae95-b38a-480d-93cd-9b34093ea539","added_by":"auto","created_at":"2026-05-08 15:26:14","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":4149021,"visible":true,"origin":"","legend":"Article File","description":"","filename":"NeuroCAVEPersonalisation.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9558323/v1_covered_aaba2863-63f8-4a14-8a25-c1e8055dbcde.pdf"},{"id":108667952,"identity":"e4e6fe6a-8a5a-4f8e-8f2d-f416f9415148","added_by":"auto","created_at":"2026-05-07 06:57:27","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":34363,"visible":true,"origin":"","legend":"Supplementary Materials","description":"","filename":"SM.docx","url":"https://assets-eu.researchsquare.com/files/rs-9558323/v1/6afa724ebc6f2967a5853606.docx"}],"financialInterests":"\u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e there is potential Competing Interest. This work involves the application of a technology developed by Gowerlabs Ltd, a UCL spin-out company, with which S.P. and N.E. are affiliated.\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from the participant’s caregiver prior to the start of the experiment. The study was approved by the ethical committee of the School of Psychological Science, Faculty of Science, Birkbeck, University of London (No. 2324007).\u003c/p\u003e\n\u003cp\u003ePP acknowledge support by the Wellcome Trust (212979/Z/18/Z).\u003c/p\u003e","formattedTitle":"Towards inclusive developmental neuroimaging: personalising virtual-reality (VR) and diffuse optical tomography (DOT) assessment for neurodivergent young children","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-9558323/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9558323/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"Wearable neuroimaging methods hold considerable promise for identifying early biomarkers of neurodevelopmental conditions, yet their application to neurodivergent young children remains limited by significant participation barriers. We investigated inclusion rates and parental experiences in a combined virtual reality and diffuse optical tomography platform. Fifty-four 3-to-7-year-olds across three groups, neurotypical, elevated likelihood of Attention Deficit Hyperactivity Disorder (ADHD), and autistic were tested twice. Neurotypical and ADHD children engaged at consistently high rates, with near-ceiling task completion and equipment tolerance. Engagement in the autistic group was markedly more variable, shaped by equipment-related sensory sensitivities, particularly the shutter glasses and the cap, that persisted across visits despite targeted adaptations. Parental insights corroborated these findings: anticipated and experienced equipment concerns differed significantly across groups and remained elevated for autistic families throughout both visits. Signal quality in the autistic group was correspondingly lower and declined between visits, partly attributable to cap loosening for more sensitive children. Drawing on iterative parental co-design and industry partnership, we developed a four-phase personalisation framework covering pre-visit preparation, in-session adaptations, and engagement with device developers. We provide the first evidence base for inclusive wearable neuroimaging in neurodivergent children and a replicable framework for moving the field beyond one-size-fits-all protocols.","manuscriptTitle":"Towards inclusive developmental neuroimaging: personalising virtual-reality (VR) and diffuse optical tomography (DOT) assessment for neurodivergent young children","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-07 06:57:01","doi":"10.21203/rs.3.rs-9558323/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"378a4caf-3634-4c6f-b14b-46d1957bd593","owner":[],"postedDate":"May 7th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Reject before peer review","date":"2026-04-30T15:57:33+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-30T11:27:06+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":67334827,"name":"Scientific community and society/Scientific community/Research data"},{"id":67334828,"name":"Biological sciences/Neuroscience"},{"id":67334829,"name":"Scientific community and society/Social sciences/Psychology/Human behaviour"}],"tags":[],"updatedAt":"2026-05-07T06:57:30+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-07 06:57:01","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9558323","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9558323","identity":"rs-9558323","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}